Portal gas and gastric pneumatosis. A story with happy ending

An 86-year-old woman with multiple comorbidities attended the emergency department for incoercible vomiting, revealing an incarcerated umbilical hernia. Abdominal computed tomography showed a distal stomach with gastric pneumatosis and portal gas (Fig. 1). Exploratory laparotomy was performed, finding a herniated anthropyloric region, with no signs of distress (Fig. 2). Umbilical hernioplasty was performed and the patient was discharged without complications. Portal and gastric pneumatosis are usually ominous signs due to their frequent association with massive intestinal ischaemia and emphysematous gastritis; however, they are radiological signs that can be associated with different aetiologies such as mechanical intestinal obstruction, with a better prognosis.

Fig. 1

Fig. 2